Journal of Preventive Medicine and Public Health最新文献

Objectives: Rural housewives are integral to household management and family care, yet their sedentary lifestyles present significant health risks. This study used the transtheoretical model (TTM) to investigate strategies that encourage and maintain regular exercise habits among rural housewives.

Methods: A semi-experimental study was conducted in 2021 with 114 housewives aged 30 to 59 who attended rural health centers in Gorgan, Iran. Participants were randomly assigned to 1 of 2 groups. Data collection involved a validated questionnaire that gathered demographic information and constructs of the TTM. The intervention group participated in a comprehensive educational program, which included four 60-minute sessions. Data were collected again 6 months post-intervention and analyzed using descriptive and inferential statistics in SPSS version 21.

Results: The study encompassed women with an average age of 39.75±6.05 years, the majority of whom had educational levels below a diploma, and over 90% were married. We observed strong correlations between the processes of change, self-efficacy, and decisional balance. At the outset, there were no significant differences in demographics or model structures between the 2 groups. However, 6 months post-intervention, the intervention group exhibited statistically significant differences in the mean scores of model structures, stages of change, and body mass index (<>p<0.05).

Conclusions: This study highlights the importance of physical activity training for rural housewives. The findings suggest that the educational intervention, which utilized the TTM, significantly impacted the participants' model structures and their stages of change.

Objectives: Abrupt changes in air pollution levels associated with the coronavirus disease 2019 (COVID-19) outbreak present a unique opportunity to evaluate the effects of air pollution on influenza risk, at a time when emission sources were less active and personal hygiene practices were more rigorous.

Methods: This time-series study examined the relationship between influenza cases (n=22 874) and air pollutant concentrations from 2018 to 2021, comparing the timeframes before and during the COVID-19 pandemic in and around Thailand's Khon Kaen province. Poisson generalized additive modeling was employed to estimate the relative risk of hospitalization for influenza associated with air pollutant levels.

Results: Before the COVID-19 outbreak, both the average daily number of influenza hospitalizations and particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) concentration exceeded those later observed during the pandemic (p<0.001). In single-pollutant models, a 10 μg/m3 increase in PM2.5 before COVID-19 was significantly associated with increased influenza risk upon exposure to cumulative-day lags, specifically lags 0-5 and 0-6 (p<0.01). After adjustment for co-pollutants, PM2.5 demonstrated the strongest effects at lags 0 and 4, with elevated risk found across all cumulative-day lags (0-1, 0-2, 0-3, 0-4, 0-5, and 0-6) and significantly greater risk in the winter and summer at lag 0-5 (p<0.01). However, the PM2.5 level was not significantly associated with influenza risk during the COVID-19 outbreak.

Conclusions: Lockdown measures implemented during the COVID-19 pandemic could mitigate the risk of PM2.5-induced influenza. Effective regulatory actions in the context of COVID-19 may decrease PM2.5 emissions and improve hygiene practices, thereby reducing influenza hospitalizations.

Objectives: Children with disabilities may exhibit a multitude of symptoms, and treatment requires a multidisciplinary approach for a satisfactory outcome. Lack of awareness among physicians, lack of referral, and lack of inter-sectoral coordination have hindered paediatric practice in Tamil Nadu, a state in India with a striking childhood disability rate that warrants a timely interdisciplinary approach. However, the perspectives of paediatricians on paediatric physiotherapy are unknown. The aim of the study was to investigate the perspectives of practicing paediatric physicians in Chennai on the role of physiotherapy in paediatrics.

Methods: For an in-depth exploration, qualitative semi-structured interviews were conducted in person with 10 paediatricians. Audio from the sessions was recorded and transcribed, and data saturation was achieved through iterative analysis.

Results: A grounded theory analysis of the results yielded 5 domains under which the perspectives and expectations of the physicians were described, along with the barriers experienced by patients' parents as explained by their paediatrician. The responses highlighted deficits in awareness, structural support, accessibility and direct communication between physicians and physiotherapists.

Conclusions: Paediatric physicians have different opinions, and some ignorance persists concerning paediatric physiotherapy. This study warrants a proper structure of the paediatric rehabilitation unit and regular interdisciplinary meetings and focus group discussions to increase access for parents and improve patient outcomes.

Objectives: Understanding patterns of quality of life in people who inject drugs (PWID) can help healthcare providers plan and manage their health problems in a more focused manner. Therefore, the current study aimed to identify patterns of health-related quality of life in PWID in southeast Iran.

Methods: This cross-sectional study was conducted in southeast Iran on men who had injected drugs at least once during the last year. We used convenience sampling in 2 drop-in centers and venue-based sampling at 85 venues. Demographic characteristics, high-risk behaviors, and health-related quality of life were evaluated using the 5-level EQ-5D version (EQ-5D-5L) questionnaire. Latent profile analysis was used to identify patterns of quality of life.

Results: This study enrolled 398 PWID, who had a mean age of 34.1±11.4 years. About 47.9% reported a prison history in the last 10 years, 59.2% had injected drugs in the last month, and 31.6% had a history of sharing syringes. About 46.3% reported having 2 or more sexual partners in the last 6 months, and 14.7% had a history of sex with men. Out of the 5 EQ-5D-5L profiles, the fifth profile had the most people (36.6%). Most variations in quality of life were related to pain and discomfort.

Conclusions: We showed that the pain and discomfort dimension of EQ-5D-5L had more variation in PWID. This finding will be useful for allocating appropriate interventions and resources to promote health-related quality of life in this population.

Objectives: The coronavirus disease 2019 (COVID-19) pandemic led to increased mortality rates. To assess this impact, this ecological study aimed to estimate the excess death counts in southern Iran.

Methods: The study obtained weekly death counts by linking the National Death Registry and Medical Care Monitoring Center repositories. The P-score was initially estimated using a simple method that involved calculating the difference between the observed and expected death counts. The interrupted time series analysis was then used to calculate the mean relative risk (RR) of death during the first year of the pandemic.

Results: Our study found that there were 5571 excess deaths from all causes (P-score=33.29%) during the first year of the COVID-19 pandemic, with 48.03% of these deaths directly related to COVID-19. The pandemic was found to increase the risk of death from all causes (RR, 1.26; 95% confidence interval [CI], 1.19 to 1.33), as well as in specific age groups such as those aged 35-49 (RR, 1.21; 95% CI, 1.12 to 1.32), 50-64 (RR, 1.38; 95% CI, 1.28 to 1.49), and ≥65 (RR, 1.29; 95% CI, 1.12 to 1.32) years old. Furthermore, there was an increased risk of death from cardiovascular diseases (RR, 1.17; 95% CI, 1.11 to 1.22).

Conclusions: There was a 26% increase in the death count in southern Iran during the COVID-19 pandemic. More than half of these excess deaths were not directly related to COVID-19, but rather other causes, with cardiovascular diseases being a major contributor.

Objectives: Professional firefighters face various health hazards and are required to maintain both physical and mental fitness to effectively mitigate crises and respond to emergencies. Moreover, the long working hours and shift work of this profession impact sleep quality. This study investigated the quality of sleep and its associated factors among firefighters in Bangkok, Thailand.

Methods: This was a cross-sectional study of firefighters affiliated with the Bangkok Fire and Rescue Department, Bangkok Metropolitan Administration, Thailand between January 2023 and March 2023. A cluster random sampling technique was utilized to distribute 600 questionnaires to firefighters in 15 fire stations. The questionnaire addressed demographic, work-related, and environmental factors. Sleep quality was assessed using the Thai version of the Pittsburgh Sleep Quality Index (PSQI). Data analysis involved both descriptive and inferential statistics. Bivariate and multiple logistic regressions were performed.

Results: The response rate was 78.7% (n=472), and 44.1% of the firefighters reported poor sleep quality (PSQI score >5). Sleep quality was statistically associated with conflicting family relationships (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1 to 2.9), additional part-time jobs (daytime, OR, 2.4; 95% CI, 1.3 to 4.4; or nighttime, OR, 4.3; 95% CI, 1.1 to 16.7), noisy sleeping areas (OR, 1.7; 95% CI, 1.1 to 2.8), and the availability of adequate bedding (OR, 3.0; 95% CI, 1.8 to 4.9).

Conclusions: Poor sleep quality among firefighters was associated with various personal, work-related, and environmental factors. Organizations should promote policies that improve sleep quality through good sleep hygiene practices and facilities.

Objectives: The unsafe use of pesticides in agriculture represents a major hazard to human health. This study was conducted to investigate the association between pesticide exposure and health symptoms among chili farmers in northeast Thailand.

Methods: This cross-sectional analytic study included 141 chili farmers in Sakon Nakhon Province, in northeast Thailand. Data regarding health symptoms were gathered using a self-report questionnaire. A medical technician tested blood cholinesterase activity using an erythrocyte method, and an occupational medicine specialist at Ramathibodi Hospital in Bangkok, Thailand reviewed the results. Associations between personal characteristics, pesticide exposure factors, and health symptoms were analyzed using multiple logistic regression.

Results: Of the 141 chili farmers studied, 66.7% experienced pesticide poisoning, as indicated by below-normal cholinesterase levels. Fatigue was the most frequently reported symptom associated with pesticide exposure, affecting 37.6% of participants. This was followed by nausea and vomiting (31.9%), dizziness (14.9%), and dry throat (14.9%). Multivariate logistic regression analysis revealed that several factors were significantly associated with adverse symptoms: amount of work experience, volume of pesticides used, use of chemical pesticides, use of leaking containers during spraying, direct pesticide exposure while working, contact with pesticide-soaked clothing, consumption of food and drinks in the fields, and blood cholinesterase level indicating risk.

Conclusions: This study suggests potential health risks for chili farmers stemming from exposure to and contamination by pesticides used in agricultural practices. To mitigate these risks, it is essential to supply personal protective equipment and to implement educational programs aimed at improving protective behaviors among farmers.

Objectives: This study was conducted to systematically summarize trends in research concerning patients with coronavirus disease 2019 (COVID-19) as reported in Korean medical journals.

Methods: We performed a literature search of KoreaMed from January 2020 to September 2022. We included only primary studies of patients with COVID-19. Two reviewers screened titles and abstracts, then performed full-text screening, both independently and in duplicate. We first identified the 5 journals with the greatest numbers of eligible publications, then extracted data pertaining to the general characteristics, study population attributes, and research features of papers published in these journals.

Results: Our analysis encompassed 142 primary studies. Of these, approximately 41.0% reported a funding source, while 3.5% disclosed a conflict of interest. In 2020, 42.9% of studies included fewer than 10 participants; however, by 2022, the proportion of studies with over 200 participants had increased to 40.6%. The most common design was the cohort study (48.6%), followed by case reports/series (35.2%). Only 3 randomized controlled trials were identified. Studies most frequently focused on prognosis (58.5%), followed by therapy/intervention (20.4%). Regarding the type of intervention/exposure, therapeutic clinical interventions comprised 26.1%, while studies of morbidity accounted for 13.4%. As for the outcomes measured, 50.7% of studies assessed symptoms/clinical status/improvement, and 14.1% evaluated mortality.

Conclusions: Employing a systematic approach, we examined the characteristics of research involving patients with COVID-19 that was published in Korean medical journals from 2020 onward. Subsequent research should assess not only publication trends over a longer timeframe but also the quality of evidence provided.

Objectives: This study investigated the association between exacerbated economic hardship during the coronavirus disease 2019 (COVID-19) pandemic and changes in the health behaviors of Korean adolescents.

Methods: We analyzed data from the 2021 Korea Youth Risk Behavior Survey and included 44 908 students (22 823 boys and 22 085 girls) as study subjects. The dependent variables included changes in health behaviors (breakfast habits, physical activity, and alcohol use) that occurred during the COVID-19 pandemic. The aggravation of economic hardship by COVID-19 and the subjective economic status of the family were used as exposure variables. Multiple logistic regression analysis was utilized to calculate the prevalence odds ratios (PORs).

Results: Severe exacerbation of a family's economic hardship due to COVID-19 was negatively associated with the health behaviors of adolescents, including increased breakfast skipping (POR, 1.85; 95% confidence interval [CI], 1.55 to 2.21 for boys and POR, 1.56; 95% CI, 1.27 to 1.92 for girls) and decreased physical activity (POR, 1.37; 95% CI, 1.19 to 1.57 for boys and POR, 1.38; 95% CI, 1.19 to 1.60 for girls). These negative changes in health behaviors were further amplified when combined with a low subjective family economic status.

Conclusions: The experience of worsening household hardship can lead to negative changes in health behavior among adolescents. It is crucial to implement measures that address the economic challenges that arise from stressful events such as COVID-19 and to strive to improve the lifestyles of adolescents under such circumstances.